Diurnal variation in admission troponin concentrations in patients with chest pain in the emergency department

Roos, Andreas; Holzmann, Martin J.

doi:10.1016/j.clinbiochem.2018.02.003

Cited by 6 publications

(3 citation statements)

References 125 publications

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“…In our setting, plasma troponin I levels were increased by 2-fold when the ligation was placed during the active period of the day (ZT14 and ZT20) ( Figure 3C ). While some evidence exists for the presence of diurnal rhythms in the concentration of cardiac troponin T in healthy volunteers ( Fournier et al, 2017 ), a large cohort study with patients with chest pain but no MI nor acute condition that would justify increased troponin levels, found no evidence of diurnal variation in cardiac troponin T concentrations ( Roos and Holzmann, 2018 ). In addition, a clinical trial evaluating the diagnostic accuracy of cardiac troponin I for acute myocardial infarction, found no differences in the levels of troponin I between patients admitted in the morning or in the evening ( Wildi et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Circadian Dependence of the Acute Immune Response to Myocardial Infarction

Kilgallen

Akker²,

Feyen

et al. 2022

Front. Pharmacol.

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Circadian rhythms influence the recruitment of immune cells and the onset of inflammation, which is pivotal in the response to ischemic cardiac injury after a myocardial infarction (MI). The hyperacute immune response that occurs within the first few hours after a MI has not yet been elucidated. Therefore, we characterized the immune response and myocardial damage 3 hours after a MI occurs over a full twenty-four-hour period to investigate the role of the circadian rhythms in this response. MI was induced at Zeitgeber Time (ZT) 2, 8, 14, and 20 by permanent ligation of the left anterior descending coronary artery. Three hours after surgery, animals were terminated and blood and hearts collected to assess the immunological status and cardiac damage. Blood leukocyte numbers varied throughout the day, peaking during the rest-phase (ZT2 and 8). Extravasation of leukocytes was more pronounced during the active-phase (ZT14 and 20) and was associated with greater chemokine release to the blood and expression of adhesion molecules in the heart. Damage to the heart, measured by Troponin-I plasma levels, was elevated during this time frame. Clock gene oscillations remained intact in both MI-induced and sham-operated mice hearts, which could explain the circadian influence of the hyperacute inflammatory response after a MI. These findings are in line with the clinical observation that patients who experience a MI early in the morning (i.e., early active phase) have worse clinical outcomes. This study provides further insight on the immune response occurring shortly after an MI, which may contribute to the development of novel and optimization of current therapeutic approaches.

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Section: Discussionmentioning

confidence: 99%

Circadian Dependence of the Acute Immune Response to Myocardial Infarction

Kilgallen

Akker²,

Feyen

et al. 2022

Front. Pharmacol.

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“…The evidence of the adverse effect of cortisol on CMC is a clinical study that demonstrates that increased levels of the stress hormone (cortisol) are associated with increased levels of cardiospecific TnT ( Lazzarino et al, 2013 ). In addition, a number of researchers associate the increased high activity of the sympathoadrenal system with a larger size of the focus of myocardial necrosis in MI, the incidence of acute CVD and an unfavorable prognosis ( Manfredini et al, 2004 ; Arroyo Úcar et al, 2012 ; Fournier et al, 2014 ; Seneviratna et al, 2015 ; Roos and Holzmann, 2018 ; Chaulin, 2021 ; Chaulin and Duplyakov, 2021g ; Chaulin, 2021h ; Chaulin and Duplyakov, 2022 ; Mullova et al, 2022 ).…”

Section: Circadian Rhythms Of Cardiospecific Tns: Possible Mechanisms...mentioning

confidence: 99%

Metabolic Pathway of Cardiospecific Troponins: From Fundamental Aspects to Diagnostic Role (Comprehensive Review)

Chaulin

2022

Front. Mol. Biosci.

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Many molecules of the human body perform key regulatory functions and are widely used as targets for the development of therapeutic drugs or as specific diagnostic markers. These molecules undergo a significant metabolic pathway, during which they are influenced by a number of factors (biological characteristics, hormones, enzymes, etc.) that can affect molecular metabolism and, as a consequence, the serum concentration or activity of these molecules. Among the most important molecules in the field of cardiology are the molecules of cardiospecific troponins (Tns), which regulate the processes of myocardial contraction/relaxation and are used as markers for the early diagnosis of ischemic necrosis of cardiomyocytes (CMC) in myocardial infarction (MI). The diagnostic value and diagnostic capabilities of cardiospecific Tns have changed significantly after the advent of new (highly sensitive (HS)) detection methods. Thus, early diagnostic algorithms of MI were approved for clinical practice, thanks to which the possibility of rapid diagnosis and determination of optimal tactics for managing patients with MI was opened. Relatively recently, promising directions have also been opened for the use of cardiospecific Tns as prognostic markers both at the early stages of the development of cardiovascular diseases (CVD) (arterial hypertension (AH), heart failure (HF), coronary heart disease (CHD), etc.), and in non-ischemic extra-cardiac pathologies that can negatively affect CMC (for example, sepsis, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), etc.). Recent studies have also shown that cardiospecific Tns are present not only in blood serum, but also in other biological fluids (urine, oral fluid, pericardial fluid, amniotic fluid). Thus, cardiospecific Tns have additional diagnostic capabilities. However, the fundamental aspects of the metabolic pathway of cardiospecific Tns are definitively unknown, in particular, specific mechanisms of release of Tns from CMC in non-ischemic extra-cardiac pathologies, mechanisms of circulation and elimination of Tns from the human body, mechanisms of transport of Tns to other biological fluids and factors that may affect these processes have not been established. In this comprehensive manuscript, all stages of the metabolic pathway are consistently and in detail considered, starting from release from CMC and ending with excretion (removal) from the human body. In addition, the possible diagnostic role of individual stages and mechanisms, influencing factors is analyzed and directions for further research in this area are noted.

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“…Его цель -показать, присутствуют ли клинически значимые суточные изменения концентрации СТ-Т у пациентов в реальной клинической практике. Ross А, et al анализировали пациентов, госпитализированных в отделение неотложной помощи с болью в груди, но не имевших ИМ или других состояний, которые могли повлиять на уровень СТ-Т в крови [32]. Периоды времени для забора крови были следующие: 00:00-03:59, 04:00-07:59, 08:00-11:59, 12:00-15:59, 16:00-19:59 и 20:00-23:59.…”

Section: циркадные ритмы стunclassified

Circadian rhythms of cardiac troponins: mechanisms and clinical significance

2020

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Modern laboratory methods for determining biomarkers of cardiovascular diseases are highly sensitive and can detect almost single molecules in human biological fluids, significantly speeding up and improving the diagnosis of cardiovascular diseases. However, in this case, there is a decrease in specificity and it is necessary to take into account a number of additional factors that may affect the result of the study. Recent studies have shown that circadian rhythms (CR) are among these factors. This review article is devoted to the discussion of recently discovered CR of cardiac troponins (CT). A number of articles reported that, both in healthy people and in patients with a number of chronic diseases, CT concentrations change during the day. Given that modern algorithms for diagnosing myocardial infarction (MI) are based on serial studies (0-1 h and 0-3 h) of blood serum, and the values of CT in the blood serum for the diagnosis of myocardial infarction (MI) for this period of time are only a few ng/l, the CT CR can to some extent affect the accuracy of MI diagnosis. Thus, natural physiological changes in the concentration of CT during the day can be mistakenly interpreted as diagnostically significant deviations and lead to an erroneous interpretation of laboratory test results.

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Diurnal variation in admission troponin concentrations in patients with chest pain in the emergency department

Cited by 6 publications

References 125 publications

Circadian Dependence of the Acute Immune Response to Myocardial Infarction

Circadian Dependence of the Acute Immune Response to Myocardial Infarction

Metabolic Pathway of Cardiospecific Troponins: From Fundamental Aspects to Diagnostic Role (Comprehensive Review)

Circadian rhythms of cardiac troponins: mechanisms and clinical significance

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